Individual provider Active NPI

Martial Raymond Knieser, M.D.

  • Preventive Medicine/Occupational Environmental Medicine Physician
  • Fishers, IN
National Provider Identifier
1083860563
Registry record updated Jun 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preventive Medicine/Occupational Environmental Medicine PhysicianTaxonomy code 2083P0500X
License
0102828A Issued in IN
Practice address
16267 Oakford TRL
Fishers, IN 46037-7391
Phone
(317) 288-0370
NPI assigned
Aug 15, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Preventive Medicine/Occupational Environmental Medicine Physician 2083P0500X 0102828A IN Primary

Addresses

Primary practice location

16267 Oakford TRL
Fishers, IN 46037-7391

Mailing address

P.O. Box 178
7399 N Shadeland Ave
Indianapolis, IN 46250-2052
Phone (317) 288-0370

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0102828AINMDPreventive Medicine/Occupational Environmental Medicine Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1218758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371513600000",
    "number": "1083860563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 178",
            "address_2": "7399 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502052",
            "telephone_number": "317-288-0370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16267 OAKFORD TRL",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460377391",
            "telephone_number": "317-288-0370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNIESER",
        "first_name": "MARTIAL",
        "middle_name": "RAYMOND",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-15",
        "last_updated": "2013-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "IN",
            "license": "0102828A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fishers, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.